Have you ever found yourself staring aimlessly into the fridge and then you realize that the remote is not in there? Or have you had that "tip of the tongue" moment when trying to give a speech?
Brain fog shows up differently in each person. For some, it’s a loss of words, for others a brief forgetfulness (‘where did I leave my keys’), for others it’s not feeling their ‘A-game’ (e.g., lack of concentration, inability to focus, etc.).
I think it's safe to say we have all had a "brain fart" moment, and some of us experience it more often then others, but what if you never had to ever again?
Brain Fog is not a condition, but rather a symptom, or set of symptoms, from a combination of lifestyle factors.
The good news... lifestyle can be changed!
Brain Fog >> brain · fog >> /brān/ /fôɡ,fäɡ/
a usually temporary state of diminished mental capacity marked by inability to concentrate or to think or reason clearly
feeling foggy, mental fog, abnormal consciousness, unclear, unfocused, sluggish thinking, brain fart
first known use:
1853 - along with: carcinogen, underinformed, boredom, altruism, neuropathology, and purposeful
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WHAT IS BRAIN FOG
Most of us generally know what brain fog is, but what does it mean on a biochemical level?
Let’s talk about what it means on a scientific level when we talk about ‘brain fog' - meaning the causes and biological imbalances that cause it.
Brain fog is not a diagnosis; it’s a general term that describes a collection of symptoms such as forgetfulness, lack of mental clarity and concentration, confusion, issues with short-term memory, or the inability to focus on a task.
Brain fog is a sign that your lifestyle needs an upgrade.
We all have days like this, but if you experience brain fog on a regular basis, there might be a nutritional deficiency or an underlying health issue. Once you can identify the cause of brain fog, you can take action.
WHAT CAUSES BRAIN FOG?
: physiological stress on the body that is caused by the cumulative damage done by free radicals inadequately neutralized by antioxidants and that is held to be associated with aging
: a local response to cellular injury that serves as a mechanism initiating the elimination of noxious agents and of damaged tissue
: the state produced by the establishment of one or more pathogenic agents
: a substance used as a medication or in the preparation of medication
: marked by the absence of wakefulness and by the loss of consciousness of one's surroundings, the occurrence of dreaming, and changes in brain activity and physiological functioning - considered essential to the restoration and recovery of vital bodily and mental functions
: a product of living cells that circulates in body fluids (such as blood) or sap and produces a specific often stimulatory effect on the activity of cells usually remote from its point of origin
LET'S BREAK IT DOWN
Oxidative stress is caused by either excessive reactive oxidative species (ROS) production or reduced antioxidative defense system.
ROS result from poor diet, smoking, sedentarism, environmental pollution, stress, and lack of sleep.
Can lead to cell or tissue damage, cell death, and chronic disease.
Affects parts of the brain such as the cortex, hippocampus, and striatum that are in charge of memory.
stresses your body and consumes nutrients such as vitamins B, C and E as well as magnesium
Inflammatory foods and environmental factors can increase pro-inflammatory cytokines in the blood and brain, causing low-grade inflammation that can lead to brain fog
You could be walking around with a viral, fungal, or bacterial infection with little to no other symptoms other than brain fog. One of the most common infections is an overgrowth of a yeast, Candida, that occurs naturally in our bodies.
Candida is a fungus that hides in your mouth, gut, genitals and urinary tract. It can overgrow from stress, high-sugar diet, or antibiotic use that leads to an imbalance of “good” versus “bad” bacteria in the gut. While it can also occur in men, Candida overgrowth and chronic infections are more common in women.
Because your gut communicates directly with your brain, miscommunication can alter your memory capabilities.
Many prescription drugs, even the most common ones, can contribute to the development of brain fog symptoms.
Benzodiazepines (for anxiety) act directly on the parts of the brain that convert short-term memories into long-term memories.
Statins (for hypercholesterolemia) lower cholesterol everywhere in the body, including the brain, where it is needed for proper function.
Painkillers change chemical signals associated with cognition.
Beta-blockers (for hypertension) also block chemical messages (neurotransmitters) in the brain.
Sedatives (for sleep) can act on the same brain pathways and chemical messengers as benzodiazepines.
Sleep aids can cause amnesia as a side effect.
Antihistamines (for allergies) have a sedative effect and can also cause brain fog.
Many prescription drugs increase brain inflammation and impair hormone function. If you take medications regularly and have noticed changes in your mood and energy, talk to your doctor about your brain fog symptoms.
LACK OF QUALITY SLEEP
Lack of quality sleep can impair your brain function, even if your body feels rested.
Sleep deprivation disrupts our brain cells’ ability to communicate with each other, leading to temporary mental lapses that affect memory and visual perception.
There are other factors to consider. Sleep apnea, a common breathing disorder in which air to the brain is restricted, can cause brain fog. The lack of oxygen can cause brain arousal in all sleep stages, resulting in your body not receiving the high-quality, highly-oxygenated sleep it requires. So, you wake up in a fog that will adversely affect your energy and metabolism all day.
A person can experience hormonal imbalances regardless of their sex or stage of life. Hormones, when they are in balance, prevent brain fog. However, when hormones are out of balance, the brain may not properly sense and adjust your hormone levels, and the body may suffer.
Short-term memory changes in women can be attributed to elevated levels of progesterone and estrogen.
Brain fog is also a common symptom of PMS. In a typical cycle, progesterone levels rise in the two weeks leading up to your period, which has been linked to decreased serotonin - a neurotransmitter that boosts mood and helps you focus.
Also, some proteins activated by estrogen in the brain are linked to memory and attention. Because estrogen fluctuates during the menstrual cycle, this could explain why some women experience brain fog during their periods.
During pregnancy, these hormonal changes can cause forgetfulness.
During menopause, estrogen decreases can cause memory issues and brain fog.
On the other hand, in men, a lower testosterone level at any age can explain mental fatigue.
Our body produces cortisol to help us react to danger and escape from ancient predators. But, there are not so many lions and tigers around any more, right? However, our brains sense stressful stimulus as threats and increase cortisol, which has a negative long-term impact on brain function.
Stress effects include feeling “wired but tired,” weight gain, suffering hormonal imbalances, sexual dysfunction, insomnia, depression, anxiety, memory issues, and brain fog.
When you eat too much sugar or refined carbs, your insulin spikes to reduce blood sugar levels, thus, causing brain fog. As a result, you store fat no matter what you try. The key is to keep blood sugar relatively stable, avoiding these insulin spikes during the day.
Thyroid hormones can also be an important contributor to brain fog. They connect directly with the brain to regulate energy, metabolism, and executive function. Both hypo- and hyperthyroid can cause memory issues.
When your thyroid function is low, your brain function is low, often causing brain fog, slow processing speed and reflexes, cognitive impairment, weight gain, fatigue, depression, and irritability among others.
Low thyroid function can be caused by dietary factors, such as low iodine intake, or as a result of a genetic variation that limits T4 to T3 (thyroid hormones) conversion in the brain.
STRESS AND THE BRAIN
Have you ever gone into the kitchen and forgotten what you were going to grab? Or looked for your keys for what felt like hours and they were in your hand? Most of us have suffered from what many refer to as “brain fog” at some point or another.
Brain fog looks different for everyone.
Persistent brain fog or inability to think clearly can be detrimental to your job, relationships, and quality of life. As a Functional Medicine Provider, my mission is to uncover the root cause. One of the most common causes of brain fog I see in practice is stress and hormone imbalances.
HOW DO STRESS-RELATED HORMONAL IMBALANCES IMPACT COGNITIVE HEALTH?
You have a master hormone called pregnenolone that is derived from cholesterol (not all cholesterol is bad) This hormone has been coined the “cognition hormone” since it has been shown to help with brain health (neuroprotective) and possibly reduce the risk of Alzheimer’s.
Pregnenolone is typically converted into progesterone and DHEA. However, during periods of increased stress and cortisol there is a pregnenolone steal or diversion, depending on the source.
In other words, your body takes the master hormone and converts it into cortisol instead of progesterone and DHEA. Overtime pregnenolone becomes deficient and cortisol becomes imbalanced. This can negatively impact cognition and mental clarity, not to mention trigger anxiety.
Have you ever noticed that the more stressed you get, the less efficient you are at work?
There is a fine line between eustress and distress.
Eustress which is beneficial stress helps you do your job effectively and efficiently. If stress becomes heightened, you can easily get into a state of distress. If the stress is temporary, your body will return to homeostasis or balance. However, if the stress becomes chronic your hormones will be negatively affected.
At STAT Wellness, we check patients pregnenolone in the morning and cortisol at 4 points during the day to evaluate how your body is managing stress with a saliva test.
Below is an example of the cortisol curve.
Another important hormone for brain health is progesterone and as we discussed earlier pregnenolone is converted into progesterone and DHEA.
As you can imagine, if the master hormone becomes deficient so does its byproducts. Progesterone has been shown to help with heart health, brain health, anxiety, and inflammation.
Well, what do we do about it?
It's easy... have no stress in your life.
Just playing! That would be impossible and actually not beneficial.
Nobody can avoid stress. However, we can change our perception (or recovery time/self-care).
" it is not the load that breaks you, it is how you carry it"
- Lou Holtz
Self-care and saying “no” to good things so you can say “yes” to great things is a key element of keeping your hormones in homeostasis.
5 QUICK TIPS - MANAGE STRESS, BALANCE HORMONES, AND IMPROVE COGNITION
PRIORITIZE SLEEP - You need 7-9 hours of uninterrupted sleep per night. I do not recommend more or less as they seem to have some of the same potential side effects including metabolic disease, cognitive issues, obesity, and heart disease.
EAT HEALTHY FATS - Cholesterol is the precursor of pregnenolone so it is important to eat healthy fats to boost HDL or “healthy” cholesterol. Our brain is also our fattest organ so consuming healthy fats is a great way to fuel your brain. If you struggle with inflammation and brain fog, consider transitioning to a Mediterranean diet loaded in healthy fats like salmon and olives and low in processed foods such as bread, pasta, and baked goods.
ADD PHOSPHATIDYLSERINE - This is a phospholipid that helps protect cell membranes. It also helps with memory and cortisol levels. I recommend 100 mg twice a day; however, it is important that you consult with your local healthcare provider before implementing new supplements.
EXERCISE - Moving increases circulation and communication from the left and right side of your brain. This does not need to be intense cardio, just going for a 20 minute walk can help with stress and cognition.
ADD ADAPTOGENS - These are superfoods that help your body find balance. Some of my favorite adaptogens are cordyceps mushrooms, ashwagandha (if you aren’t sensitive to nightshades), and rhodiola. However, if you are really suffering from brain fog Lion’s Mane has been shown to have neuroprotective properties and might boost mental clarity.
THE GUT-BRAIN CONNECTION
Have you ever heard the term “ butterflies in the stomach”?
Well, there aren't a bunch of butterflies in your belly, but there is a colony of something else living in there... the human digestive tract is home to more than 100 trillion bacteria - more than the stars in our galaxy, the milky way.
Over the past several years, we have become increasingly interested in research on how gut microbiome or gut bacteria can affect our overall health and particularly brain health.
The gut is often referred to as the “second brain” and for good reason...
The “Gut Brain Axis” is the bidirectional communication between the brain and peripheral intestine or gut.
In humans, the most enthralling evidence of a gastrointestinal microbe-brain interaction surfaced more than 20 years ago, which was the observation of dramatic improvement of liver disease after the administration of oral antibiotics. There is also emerging data to support the role of microbiome in influencing anxiety and depression.
More recently, we have become interested in concept of “dysbiosis” which occurs when microbiome in gut become “imbalanced”.
A balanced and healthy gut begins at birth.
The first bacterial contribution for a healthy gut is made at the time of birth while passing through the vaginal canal.
Several studies have shown that differences between the bacteria and other microorganisms in cesarean- and vaginally born babies are significant. As a result cesarean-born babies have a higher risk of health problems in later life. This can particularly be seen in the case of brain health as well.
Newer research suggests that an example can be witnessed in autistic patients who have been shown to have alterations in specific microbiota. Interestingly, this may actually be proportional to the severity of the disease.
According to research, the first three years of life largely determine the adult gut flora. By the age of 3, the gut microbiome are very similar to that of adults.
Therefore, it becomes important to understand how gut health can affect brain health and how nutrition can affect the gut health.
The existence of the gut-brain axis was proposed in the landmark study in 2011 by Sudo and colleagues that discovered an impaired stress response in germ-free mice. Another study from 2017 on mice showed how “germ free mice” were more prone to developing anxiety.
Other studies using germ-free mice not only supported this existence, but also the idea that the gut-brain-axis extends even beyond these two systems into the endocrine, neural, and immune pathways.
THE GUT BRAIN AXIS VISUALIZED
The way in which Gut Brain Axis works is through hormones, neurotransmitters and immunological factors. Serotonin is a signaling molecule that can be found in the gut and helps communicate with brain.
Neurotransmitters in the gut send signals to the brain
This is why what we eat matters for brain health. A great example of this is the use of probiotics.
The utility of probiotics is debatable as these are not regulated by the FDA. There is some notable research on the use of fermented foods with gastrointestinal and cognitive benefits, however, until more evidence is available, probiotics can't be considered a reliable front-line therapy for anxiety and depressive disorders as some would suggest.
Over recent decades, modern eating patterns have undergone major compositional changes.
There has been “Westernization” of diets with increased intakes of red meat, and refined sugars. This has certainly resulted in modifications to the gut microbiome, which may contribute to the higher incidences of chronic inflammation and diseases, like anxiety and depression and even alzheimers.
The promising evidence of a gut–brain axis regulation in certain neuropsychiatric disorders calls for further research to investigate gut microbiome interventions as novel therapeutic interventions.
In fact, dietary interventions to treat the gut–brain axis dysfunction may pose potential as therapeutic strategies for psychiatric disorders.
FOR SOME INTERESTING RESEARCH ON THE GUT-BRAIN AXIS RELATED TO THIS ARTICLE:
BIOHACKING BRAIN FOG 101
STEP # 1 >> LESS SUGAR - MORE COMPLEX CARBS
Removing from your diet all processed foods that are loaded with sugar is the first step.
While refined sugar increases inflammation, complex carbs found in fruits and vegetables do the opposite.
So, eat complex, unprocessed carbs throughout the day in moderation.
Focus on filling up on brain foods that improve focus and memory such as sweet potatoes, yams, fruits, raw dairy and ancient grains; all good sources of serotonin-boosting carbs.
Keep in mind, that low but stable complex carbs intake will prevent insulin spikes and keep you more emotionally balanced and your brain focused.
STEP # 2 >> MORE PROTEIN + HEALTHY FAT
We require a steady supply of amino acids and essential fatty acids to make all the brain chemicals that we need to think clearly.
Our bodies require essential amino acids (those that we can’t make on our own) for hormone production and proper brain function. Protein sources like meat, dairy products, fish and eggs provide these amino acids.
We also need healthy fats to produce hormones and fight inflammation.
Inflammation is partially caused by imbalances in fatty acids and is linked to depression, cognitive decline, and weight gain.
To help with brain fog, increase the consumption of anti-inflammatory omega-3 fatty acids.
On average, it’s recommended to include 20-30% of protein (grass-fed beef, free-range eggs, pasture-raised poultry and wild-caught fish) and 30-40% of healthy fats (coconut and olive oil, avocado, and nuts/seeds) to ensure you cover your body needs and help reduce inflammation.
STEP # 3 >> REDUCE STRESS
To keep cortisol in check, we need to regularly put aside time to practice stress-reducing techniques like meditation, exercise, journaling, reading, spending time in nature, and doing things we love.
These “feel good” activities also help increase dopamine, one of the “happiness hormones.”
Make it a priority to do something fun every day, even if it’s only for a short period of time.
STEP # 4 >> GET QUALITY SLEEP
We live in a fast-food, multitasking society where productivity is overvalued and recovery time is undervalued. But, one of the fastest and more reliable ways to improve brain function is to get a good amount of quality sleep.
The hormones in your brain stay in balance when your body gets adequate rest every night, at least seven hours for most adults.
So, the more things you need to get done, the more focused and sharp you need your brain to be, the more sleep you need.
Brain fog is also triggered by lack of sleep because this raises cortisol levels. High cortisol reduces dopamine levels, creating a vicious cycle of poor moods and behaviors.
STEP # 5 >> EXERCISE IN MODERATION
Exercise lowers inflammation, reduces stress and increases energy levels, but only in moderation. Excessive exercise can produce hormonal imbalance and fatigue. Moderate and regular exercise can help balance hormones, improve insulin resistance and help you to get better sleep.
Exercise releases natural endorphins, boosting your stamina and lifting your mood.
But, overexerting yourself without enough rest increases cortisol and depletes the body of electrolytes, nutrients and energy. That’s why it’s vital to get the appropriate amount of rest between workouts.
Symptoms of brain fog from overtraining are your body’s way of letting you know that you need to stop.
The type of exercise you do should make you happier and more energetic, not the opposite!
STEP # 6 >> CHECK FOR HORMONAL IMBALANCES
Low thyroid function, adrenal insufficiency and chronic fatigue syndrome can all increase symptoms of brain fog.
These hormonal imbalances are mostly caused by the same factors as inflammation, a poor diet, possible sensitivities and allergies, stress, and lack of sleep and rest.
Adjust your diet to balance hormones naturally and also aim to cut back or eliminate caffeine, alcohol and excess sugar and simple carbs.
Also avoid inflammatory hydrogenated oils, processed and packaged foods, which drain your energy and leave you even more tired.
STEP # 7 >> CHECK FOR FOOD ALLERGIES OR SENSITIVITIES
When people suffer from a food sensitivity but don’t cut out all sources from their diets, they experience gut-related damage that affects brain function.
Inflammation (due to allergies and sensitivities) can cause significant changes in the gut microbiota.
An allergic reaction triggers inflammation, which affects everything from nutrient absorption to hormone production, and especially the gut-brain connection.
STEP # 7 >> TRY SOME NATURAL NOOTROPICS
Certain supplements can help clear up brain fog and get the wheels in motion while you’re in the process of optimising your health. However, there’s no substitute for a balanced diet, quality sleep, regular exercise, and a healthy lifestyle.
Here is a list of supplements that can help your body recover from brain fog:
L-THEANINE - an amino acid found in tea capable of crossing the blood-brain barrier, enhancing cognitive function, and producing relaxation and calm.
LIONS MAINE - a medicinal mushroom generally recognized for clearing brain fog, improving focus, and promoting neurogenesis.
TURMRIC (CURCUMIN) - the best natural anti-inflammatory supplement. There are many ways to up your daily consumption of turmeric. A nice way to include turmeric in your daily routine is as a turmeric latte (or golden milk). You can make it yourself with coconut or almond milk, ghee, turmeric, ginger, cinnamon, black pepper (to increase bioavailability of curcumin), and honey (optional).
HOLY BASIL - an adaptogenic herb well known for its ability to lift mood, reduce brain fog, and improve mental clarity.
MACA - great for brain fog as it’s high in vitamins B, C, and E, increases energy levels, and helps to balance hormones.
ASHWAGANDHA - a powerful adaptogenic that supports harmony, whole-body balance, and vitality, and stimulates the production of nitric oxide in the body, which reduces oxidative stress.
Omega-3 fish oils - effective at helping lower inflammation, omega-3s balance the ratio of fatty acids in your diet and support brain health.
B VITAMINS - deficiencies in various B vitamins can leave you feeling sluggish and moody. B vitamins help convert nutrients from the foods you eat into usable fuel for the body, so taking a B complex supplement can make sure you’re in the optimal range.
SEAWEED - one of the most iodine-rich foods, with iodine being essential for normal thyroid hormone production.
BLUEBERRIES - these berries have a beneficial effect on cognitive function and improve memory, plus they are delicious!
MEET THE CONTRIBUTORS
Evguenia Alechine - has a PhD in Biochemistry and a knack for sharing knowledge about health optimization and wellbeing. She’s also a biohacker, digital nomad, and holistic yoga and acroyoga teacher. Currently she is focused on a global leadership program called Homeward Bound for women in STEM that aims to change our paradigms around climate change.
Dr. Evguenia Alechine, PhD
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